IMMEDIATE BREAST RECONSTRUCTION AFTER MASTECTOMY IS SAFE, ASPS
STUDY SAYS RECONSTRUCTION DOES NOT IMPEDE CHEMOTHERAPY, RECOVERY
OR DIAGNOSIS OF REOCCURRENCE
November 6, 2002
Debunking the myth that women with
locally advanced breast cancer must wait until after chemotherapy
to have their breast reconstructed, a study presented today at
the ASPS/PSEF/ASMS 71st Annual Scientific Meeting in San Antonio
found that immediate free flap reconstruction for women with breast
cancer is safe and psychologically beneficial.
The study, which followed 170 patients
with locally advanced breast cancer, found that immediate reconstruction
did not delay post-operative chemotherapy, prolong recovery or
hinder the diagnosis of local cancer reoccurrence.
a breast is traumatic," said ASPS Member James Watson, MD,
and participating surgeon in the study. "As a board-certified
plastic surgeon, I wanted to ensure that immediate breast reconstruction
was safe for my patients and would make the healing process easier.
The findings in this study will allow women to start healing sooner
psychologically, knowing that their decision will not impede their
physical progress against breast cancer."
The paper states that women participating
in the study were pleased with their immediate reconstruction
experience, indicating an immeasurable emotional benefit patients
gain by having the reconstruction right away.
According to the findings, the majority
of patients were either satisfied or very satisfied with their
reconstruction and, if they had to, would have it done immediately
after their mastectomy again. Also, the majority of women agreed
they would recommend immediate reconstruction to a friend or colleague.
Through the study, Dr. Watson found
that immediate free flap reconstruction - where a section of muscle,
fat and skin are removed from the abdomen, buttocks or thigh regions
and reattached in the breast using microsurgical techniques -
resulted in similar complications and delays of post-operative
chemotherapy to patients who delayed reconstruction. The most
common postponement for patients was waiting for the wound to
heal. However, the maximum delay was only three weeks, which did
not have significant oncological impact on their post-operative
Also, while there were local reoccurrences
of the cancer, physicians were able to diagnose the cancer's return
quickly, resulting in no delay for additional treatment. Most
local reoccurrences were located at the mastectomy scar or in
the mastectomy flaps, which could be diagnosed by a physical exam
"An added benefit to reconstructing
the breast immediately is that it's easier for the oncology surgeon
to complete the mastectomy. Often, the breast cancer is so large
or involves so much skin that the surgeon has to remove additional
skin in the region, making it difficult to reserve enough tissue
to close the wound," stated Dr. Watson. "With immediate
reconstruction, the oncologic surgeon can eliminate more breast
skin to ensure the cancer is removed and use the skin from the
free flap procedure to close the wound."
Last year, more than 190,000 women
were diagnosed with breast cancer. More than 80,000 women opted
for breast reconstruction following a mastectomy, according to
ASPS 2001 statistics.
Access to breast reconstruction following
a mastectomy has increased due to the passage of the Women's Health
and Cancer Rights Act 1998, proudly supported by ASPS, which mandated
insurance coverage for breast reconstruction and the alteration
of the opposite breast for symmetry for women who have undergone
"With the finding that reconstruction
right after mastectomy is safe, women can maximize their opportunity
to not only heal physically but also psychologically right away,"
said Dr. Watson. "Before, women had to wrestle with their
changed body image after losing a breast while physically recovering
from their battle with cancer. Now, they don't have to delay the
psychological healing process of beating breast cancer and celebrating
ASPS, founded in 1931, is the largest
plastic surgery organization in the world and the foremost authority
on cosmetic and reconstructive plastic surgery. ASPS represents
physicians certified by The American Board of Plastic Surgery
(ABPS) or The Royal College of Physicians and Surgeons of Canada.
For referrals to ABPS-certified plastic surgeons in your area
and to learn more about cosmetic and reconstructive plastic surgery,
call the ASPS at (888) 4-PLASTIC (1-888-475-2784) or visit www.plasticsurgery.org.
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